Provider Demographics
NPI:1639599517
Name:OSBERG, RORY ELLEN (LMFT)
Entity Type:Individual
Prefix:
First Name:RORY
Middle Name:ELLEN
Last Name:OSBERG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 BASS LAKE RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-3072
Mailing Address - Country:US
Mailing Address - Phone:763-560-8331
Mailing Address - Fax:763-560-8431
Practice Address - Street 1:3300 BASS LAKE RD
Practice Address - Street 2:SUITE 500
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-3072
Practice Address - Country:US
Practice Address - Phone:763-560-8331
Practice Address - Fax:763-560-8431
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-18
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2652106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist